26 April 2006

I know it is completely unethical to share any details from patient appointments, but I just have to. It took me a few minutes of careful redirection when determining the reason for CL’s visit today (not her real initials). A few mind-warping minutes of wondering if it was too late for my coffee or if I needed to practice focusing a bit more. I couldn't understand her (English) description of her chief complaint. She said her vagina was "sweck" and "swappy." She rolled those terms out like everyone knows them. She is not a teen. It is not some new generation thing (please correct me if I am wrong). I have been privileged to learn “dukie” (noun, shit) and “nut” (past tense of the verb to ejaculate), and a rash of other terms previously unheard by me but understood in context because I am somewhat smart (and it is my job to understand my patients).

Anyway, it took me those few minutes to realize my patient was completely nuts (not to be confused with nut). She went on to describe “you know, when you do [some reference for a drug] and get that white flowing feeling when it overflows over your underwear, when your skin is following one direction and the rest of you has gone to [a place or mental state].” Have you had this problem before?“ Well, I’ve been taking in a lot diamonds and properties and that usually makes it sweck. I shouldn’t be telling you, but I’m pulling it all together now- you know when all the parts just get in line?’ Are you sexually active? “Oh yeah, but my husband is so gorgeous and famous, he has sex for cigarettes or necessities sometimes. Women can’t resist him.”

CL had a simple yeast infection. I had a fabulous time talking with her in her unmediated state. I used to work with mentally ill adults, but never doing GYN care. It’s a whole new menu of word salad. And I love word salad. That’s where we are with Stella now. “Mama can take Baba for nana,Sweetie.” “Did you make coco? I think your diaper has uh-oh in it.” “Put down the watering can, Stella.” “Agua!”

Was Stella really already 3 months old when I wrote this poem? I didn't get out before then!? January 7 was the first draft. That's when the in-laws were here. It must be so. The emptiness of that first hour away from her was a hard surprize. I remember it well.

Today I left home at noon and my only contact with Stella before 7 am tomorrow will be in a few moments -when I sneak to her side and check the blanket on my way to bed. And it is easy. Every Monday is like this; I see patients until after 9pm.

22 April 2006

No one talks about weaning. It's not surprising since breastfeeding isn't in the top 10 dinner conversations, but even among breastfeeding moms the getting off the breast passes without much comment. Like initiating this basic act, the ending of it can come with suffering. Feeding Stella was excruciating and humiliating for the first ten weeks. It felt like she was cutting off my nipple with an expertly sharpened pair of scissors. At week eight, it dulled to something akin to a firm slap on new sunburn. I avoided nursing in public. I cried a lot, especially at the 2 and 4 am feedings when I was too tired to get her into the right position and too tired to have any emotional strength in the face of this awful failure. And it did feel like a failure.

Now we skip ahead past 15 months of good eatin'. Breastfeeding carves out quiet time on busy days, makes a perfect soother, and nourishes my daughter and my ego (yes, it finally worked!). And after every cracked nipple, every pulled up shirt, we are weaning. I started 3 or 4 months ago by removing the mid-day and late afternoon snacks. She gets cow or goat milk or yogurt at these times. In March I removed the naptime nurse. That one has been really difficult. Stella screamed and clawed at my chest the first few days. I held her until she cried herself drowsy and then put her in the crib. Twice a week the nanny puts her down for her nap without a boob, another day she falls asleep in the car on the way home from grocery shopping or the park- so it's only 4 days max I need to do it. And it is working- she will ask to nurse by signing, but will accept a bottle of milk or just some rocking and then ask for the crib.

The surprise is my own sadness. The first day she realized I wasn't going to nurse her for the nap- and more or less accepted it, I wept when I left her room. After a horrific beginning, I thought I would praise the day my breasts became my own again. There is a freedom I am regaining now, and for that wonder, I am grateful. But seeing a window into the near future- when she won't need me in that core way- carves a strange wound in my heart. Is this how I will feel when she makes all her big steps toward independence? Proud, but weeping?